Panic attack: what it is and what the symptoms are

More and more frequently, and particularly since the COVID-19 pandemic, people are talking about anxiety and panic. Many people have experienced prolonged states of anxiety and even full-blown panic attacks

Many young people suffer from them, at school or in other contexts, many workers after months of smart working have to return to crowded and claustrophobic open spaces that can be good for the mood of many, but can also terrify others.

What is a panic attack?

A panic attack is the sudden onset of a distinct and brief period of intense discomfort, anxiety, or fear accompanied by somatic and/or cognitive symptoms.

Panic disorder consists of the occurrence of repeated panic attacks typically accompanied by fear of a future attack (fear of fear) or behaviour to avoid situations that may predispose to attacks.

Many people experience a panic attack once or twice in their lives.

However, only a fraction of them will develop a full-blown panic disorder, amounting to 2-4% of the general population.

Panic disorder is defined by at least one month of persistent fear of recurring attacks (or their effects), which characterises the so-called panic march.

Panic disorder: what are the symptoms?

Both physical and mental symptoms may occur during a panic attack.

Panic attacks cause intense fear with a sudden onset, often without warning.

An attack typically lasts between 5 and 20 minutes, but in some more extreme cases symptoms can last for more than an hour due to the emotional connection that amplifies the symptom.

The experience of a panic attack is different for everyone and symptoms can vary

Among the most common are:

  • Feeling scared and nervous
  • Chest pain
  • Hunger for air
  • Rapid heartbeat
  • Headaches
  • Stomach ache
  • Dizziness
  • Sweating or shivering
  • Fear of dying, losing control or going mad, feeling dizzy
  • Sense of unreality and strangeness in the perception of one’s own body
  • Sense of unreality towards surrounding things
  • Sense of confusion.

One of the most distressing symptoms is often the perception of a lack of air, which in many cases leads to a tendency to try to breathe even more deeply or quickly, which makes the symptoms worse.

If hyperventilation lasts for a long time, these symptoms are also likely to occur:

  • Dizziness
  • Nausea
  • Feeling of difficulty in breathing
  • Feeling of constriction, weight or pain in the chest
  • Muscle paralysis
  • Increased apprehension and alarm, even to the point of fear that something terrible is going to happen, such as a heart attack, brain haemorrhage or even death.

How is panic disorder treated?

Although the symptoms of panic disorder can be overwhelming and frightening, proper treatment can help patients manage them.

Therefore, it is necessary to seek professional help from an experienced panic disorder practitioner.

Therapies include:

  • Cognitive behavioural therapy (CBT) – This therapy helps patients to change their thoughts and actions so that they can learn effective techniques for managing panic, and also other emotions that can influence its onset. Anxiety can be very sneaky, the more you fear it and want to get rid of it, the more likely it is to manifest. Getting to know it, not fearing it, and knowing how to manage it is fundamental in the course of treatment, the duration of which, depending on the severity, can last from about four to 12 months.
  • Medications: There are drug therapies that can significantly help people with panic attacks. The doctor will assess which drugs are best for each patient and explain how they work in order to dispel any misconceptions about the dreaded ‘psychotropic drugs’. Generally, medication with serotonergic drugs is maintained for about a year, after which the doctor decides how to proceed to discontinuation.
  • The combined approach, i.e. drug therapy and cognitive-behavioural psychotherapy, is the one that the scientific literature suggests is the most effective, but it is essential to carry out an accurate initial assessment and then decide on the most suitable intervention for the individual.

If the effectiveness of these treatments in the short and medium term is undisputed, it is also true that some patients tend to relapse either due to predisposing factors, genetic and character (anxious temperament) or as a consequence of stressful and adverse events (bereavements); it is therefore essential to try, in a second phase of therapy, to work with one’s therapist to avoid, where possible, relapses and relapses.

To take heart from this latest piece of news, which often frightens patients right from the start of their journey, it should be pointed out that any relapses can be more quickly identified and treated early, precisely because of the work done previously.

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